What is Paranoid Personality Disorder?
Most of us have experienced paranoia at some point. Perhaps it was within the context of a romantic relationship, maybe it was regarding the intentions of a colleague at work or perhaps it is something you experience when walking home at night. These are all relatively common experiences, however for people with paranoid personality disorder, these tendencies can become problematic in almost all aspects of life.
Paranoid personality disorder is a mental illness that refers to people who exhibit a pattern of pervasive distrust and suspiciousness of others, such that their motives are perceived as malevolent. This is generally present in a variety of contexts. According to the DSM-5, to meet the criteria for paranoid personality disorder a person must meet four of the following seven symptoms.
Firstly, people with paranoid personality disorder will often suspect, without sufficient basis, that others are exploiting, harming or deceiving them. They will often feel suspicious of others, suspecting that they could be attacked in some way at any time.
Secondly, these people are often preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates. Any perceived behaviour that indicate a lack of trust or loyalty, supports this assumption however any signs of loyalty are not able to be taken as face value and are therefore also perceived as an attempt at manipulation.
Thirdly, people with paranoid personality disorder rare reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her. As a result of this fear they will often give vague answers to personal questions or claim that it is none of their business.
Fourthly, people with this disorder often read hidden meaning or threatening meanings into benign remarks or events. For example, an offer by a co-worker to help may be perceived as a criticism that they don’t know what they are doing or are incompetent of performing the task on their own.
Fifthly, these people will persistently bear grudges(e.g. will be unforgiving of insults, injuries or slights), though in most cases these perceived attacks are often misinterpreted or miniscule.
Sixthly, people with paranoid personality disorder will perceive attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack. Seventhly, people with paranoid personality disorder have recurrent suspicions, without justification, regarding fidelity of spouse of sexual partner. This can often put significant strain on one’s romantic relationships.
Paranoid personality disorder should not be diagnosed if this pattern of behaviour occurs exclusively during the course of schizophrenia, a bipolar disorder or depressive disorder with psychotic features, or another psychotic disorder and is not attributable to the physiological effects of another medical condition.
People with paranoid personality disorder can be difficult to maintain relationships with, even in the context of family or romantic partners. Their suspiciousness of others can be expressed in different ways depending on the individual. While some may present as argumentative and defensive to perceived threats or criticism, others might instead stay quiet, preferring to safeguard themselves. People with this disorder also have a need to be self-reliant as they lack trust and do not feel they can depend on others.
What are the risk factors for paranoid personality disorder?
There is evidence that there appears to be a genetic basis to paranoid personality disorder, with the likelihood of developing this disorder appearing to increase if one has relative with this disorder or with schizophrenia; however the research is scarce on this.
Childhood trauma has also been identified as a risk factor for paranoid personality disorder, with longitudinal studies suggesting that many people with this diagnosis were subject to childhood emotional neglect, physical neglect, supervision neglect, physical abuse and sexual abuse.
What are the treatment options for paranoid personality disorder?
Often people with paranoid personality disorder are reluctant to engage in therapy due to high levels of mistrust and suspicion. These people also express a reluctance to engage in the research required to ascertain the effectiveness of therapy, limiting what is known about treatment options. Preliminary research has suggested that psychoanalysis and cognitive behavioural therapy may be effective interventions for this disorder, however further research is needed.